International Summer Program

for Skin Integrity in Japan 2018

Ito International Research Center
August, 27-31, 2018

ASSESSMENTOFDEPRESSIVE SYMPTOMS PEOPLE

WITH DIABETIC FOOT ULCER

Djoko Priyono
Nurse Staff at Kitamura Clinic
Pontianak, West Kalimantan, Indonesia
Background
Diabetes mellitus is a chronic disease that
through its complications can seriously impact
the quality of life of individuals.

The World Health Organization (WHO) is

warning that the number of people with diabetes
is rapidly increasing.
 Prevalence

7
INDONESIA
Indonesia ranked number 7
(seventh) in the world of people
with diabetes melitus.
 Prevalence
Ministry of Health (2015)

3
PONTIANAK, WEST BORNEO

Ranked number 3 in Indonesia

of people with diabetes melitus.
Cont . . .
Estimated that 15% - 25% of patients with
diabetes mellitus will develop at least one
foot injury throughout their lives
 Cont . . .

Several studies have shown

that patients with diabetic foot
ulcers were more poor quality
of life

Evans AR, Pinzur MS. Health-related quality of life of patients with diabetes
and foot ulcers. Foot Ankle Int 2005;26:32–37
 Background
Research has been developed to identify the best treatment.

However, there is a need to understand the complex process of

healing, as well as the biopsychosocial aspects purporting to
these individuals.
Cont . . .
Patients with diabetes and
comorbid depression were found
to have greater symptom severity,
increased disease burden,
disability in work and use of
medical services.

Katon WJ. The comorbidity of diabetes mellitus and depression. Am J Med

2008;121 11 Suppl 2:S8-15.
Cont . . .
Limited data are available about
depression in patient with
diabetic foot ulcer from Indonesia
Objective
This study aimed to evaluate the
intensity, degree of depression
and the depressive symptoms
presented by diabetic patients
with foot injury.
METHODS
1 Descriptive study

2 70 patients diabetic foot ulcer

Data were collected during the period

3 from March 2018 to Juni 2018

Instrument to collect data that had

4 socio-demographic and clinical
information.
The instrument used to assess
5 depression was the Beck Depression
Assessment inventory
 RESULT
• Classification of symptoms of depression in diabetic patients with foot ulcer by the Beck questionnaire

Classification of depressive symptoms N % Valid % Accumulated

%
Minimal or none 18 25,7 25,7 25,7
61,4
Mild 25 35,7 35,7 91,4
Moderate 21 30,0 30,0 100,0
Severe 6 8,6 8,6
Total 70 100,0 100,0
35,7% of patients had mild depression and 30,0% moderate
depression.
RESPONSES OF BECK DEPRESSION INVENTORY FOR DEPRESSIVE
SYMPTOMS IN PATIENTS WITH DIABETIC FOOT ULCER
Occurence of depressive Answer Occurence of depressive Answer
symptoms (n = 70) symptoms (n = 70)
Less Satisfied 54 Loss of Appetite 44
Sadness 54 Feel Guilty 44
Fatigue 51 Pessimism 43
Disqualification for Work 50 Weight Loss 39
Somatic preoccupation 50 Irritability 37
Loss of Libido 50 Self-dislike 37
Body Image Distortion 48 Sense of Failure 33
Sleep Disorder 47 Crying Crisis 33
Social Retraction 45 Punishment 23
Idencisiveness 44 Self-Accusation 19
The Idea of Suicide 0

54 (75,71%) patients had symptoms of depression: Less Satisfied, Sadness; 51

(72,86%) Fatigue; 50 (71,43%) patients had a Disqualification for Work, Somatic
Preoccupation and Loss of Libido.
 DISTRIBUTION OF DIABETIC WITH FOOT ULCERS ACCORDING TO
DATA RELATED TO THE WOUND

Variables N % Valid % Time With N % Valid %

Size of Ulcer
lesion Up to 6 Months 65 92,86 92,86
1 to 5 cm 40 57,1 57,1
7 Months to 1 year 2 2,86 2,86
6 to 10 cm 20 28,6 28,6
Above 1 Year 3 4,28 4,28
Above 11 cm 10 14,3 14,3
Relapse N % Valid % 40 (57,1%) had a size 1 to 5 cm; 65 (92,86%) patients
Yes 42 60,0 60,0 lived with the wound Up to 6 Months; and 42 (60%) had
No 28 40,0 40,0 ulcer recurrence.
Discussion
In this study, most patients had mild and moderate
depression. The depressive symptoms that showed
were: Less Satisfied, Sadness and Fatigue.

Previous study have revealed a direct directly associated

with cellular and humoral immune deficiency, which has an
impact on wound healing.

Cole-King A, Harding KG. Psychological factors and delayed healing in chronic wounds.
Psychosom Med. 2001;63:216–20.
 Conclusion & Suggestion

Through the assessment of This study proven that the DFU

depression inventory of Beck, showed patients is not only need physical
that diabetic patients with foot ulcers treatment/intervention but also need
had varying degrees of depressive psychological treatment for improving
symptoms. quality of life
Future Study
Future studies should be conducted in
order for the sample size to be increased
and the magnitude of possible changes in
the emotional aspects and their
consequences for patients with wounds
understood.
http://klinikkitamura.com/
ありがとう

TERIMA KASIH